人膝关节半月板不同测量方法的准确性和匹配性研究  

Research on the accuracy and matching degree of different methods of measuring human knee menisci

作　　者：汪喜顺 章亚东[2] 侯树勋[2] 吴闻文[2] 罗殿中[2] 顾东强 薛超[2] 赵彦涛[2] 

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第一附属医院骨科研究所,北京100048

出　　处：《中国骨与关节杂志》2014年第4期287-291,共5页Chinese Journal of Bone and Joint

基　　金：首都临床特色应用研究资助项目(Z131107002213014);首都医学发展基金资助项目(20073044)

摘　　要：目的明确X线测量方法、MRI测量方法、解剖学测量方法三者的相互关系以及准确性和匹配性。方法选取意外死亡男性膝关节6只,年龄20-45岁,排除膝关节创伤和疾患,随机编号,分别行X线标准正侧位摄像、常规膝关节MRI扫描,将所得影像数据资料导入Unisight图象分析系统对相关指标进行测量并记录,然后将膝关节离断,直视下按照我院组织库的半月板测量方法进行测量并记录相关数据。X线测量指标包括:内侧胫骨平台矢状径、外侧胫骨平台矢状径、胫骨平台冠状径、内侧胫骨平台冠状径、外侧胫骨平台冠状径。MRI测量指标包括:胫骨平台冠状径、内侧胫骨平台冠状径、外侧胫骨平台冠状径、内侧胫骨平台矢状径、外侧胫骨平台矢状径、内外侧半月板的厚度(前角、体部、后角)、内外侧半月板的宽度(前角、体部、后角)。解剖学测量的指标包括:胫骨平台冠状径、内侧胫骨平台冠状径、外侧胫骨平台冠状径、内侧胫骨平台矢状径、外侧胫骨平台矢状径、内外侧半月板的厚度(前角、体部、后角)、内外侧半月板的宽度(前角、体部、后角)。结果在半月板测量的直接指标中,除内侧半月板体部宽度、内侧半月板前角厚度、外侧半月板体部厚度的MRI测量变异系数<10%之外,所有指标变异系数均>10%。外侧半月板后角宽度及外侧半月板前角宽度的MRI测量,变异系数分别为65.97%、70.26%。半月板测量的间接指标,变异系数均<10%。半月板厚度的MRI测量总大于解剖学测量结果。3种测量方法的一致性方面存在关联,但仍有差异。结论半月板相关测量指标中,X线测量值均偏大,经MRI测量的指标与解剖学测量结果接近,MRI所测的半月板指标较X线测量指标更具准确性及稳定性,值得推荐其作为临床匹配性测量的方法,其中胫骨平台冠状径、内侧胫骨平台矢状径、外侧胫骨平台矢状径是�Objective To investigate the interrelationship among the 3 methods of X-ray, MRI and anatomical measurements of human knee menisci, as well as their accuracy and matching degree. Methods Six qualiifed knee joints were selected from male adult patients whose death was accidental and age ranged from 20 to 45 years old. The cases of knee trauma and disorders were excluded, and the other cases were numbered randomly. Standard anterior-posterior and lateral X-ray imaging and routine knee MRI scan were performed respectively, and the image data were guided into the Unisight image analysis system so as to measure and record the relevant indicators. The knee joints were amputated, and the relevant data were measured and recorded under direct vision according to the meniscus measurement method in the Tissue Bank of our hospital. The X-ray measurement indicators included sagittal diameter of the medial tibial plateau, sagittal diameter of the lateral tibial plateau, coronal diameter of the tibial plateau, coronal diameter of the medial tibial plateau and coronal diameter of the lateral tibial plateau. The MRI measurement indicators included coronal diameter of the tibial plateau, coronal diameter of the medial tibial plateau, coronal diameter of the lateral tibial plateau, sagittal diameter of the medial tibial plateau, sagittal diameter of the lateral tibial plateau, thickness of the medial and lateral menisci （ anterior horn, body and posterior horn ） and width of the medial and lateral menisci （ anterior horn, body and posterior horn ）. The anatomical measurement indicators included coronal＆amp;nbsp;diameter of the tibial plateau, coronal diameter of the medial tibial plateau, coronal diameter of the lateral tibial plateau, sagittal diameter of the medial tibial plateau, sagittal diameter of the lateral tibial plateau, thickness of the medial and lateral menisci （ anterior horn, body and posterior horn ） and width of the medial and lateral menisci （ anterior horn, body and posterior horn ）. Results Amo

关 键 词：半月板 胫骨 放射摄影术 磁共振成像 解剖学 局部 膝关节 

分 类 号：R687.4[医药卫生—骨科学]